一位少女接受血型不相容腎臟移植前行雙重過濾血漿分離術之護理經驗

A Nursing Experience of a Young Girl Preparing for ABO-Incompatible Kidney Transplantation with Double Filtration Plasmapheresis

本篇係探討一位末期腎衰竭行腹膜透析的單親少女，因腎臟捐贈來源有限，而預備接受母親腎移植的護理經驗。由於母女血型不相容，於腎臟移植前，需行雙重過濾血漿分離術以降低血液中的抗體。筆者自2012年9月3日至9月10日於血液透析室照護期間，運用Watson關懷照護理論作為護理措施指引並進行整體性評估，確認個案的健康問題為恐懼感、潛在危險性感染及照顧者角色緊張。筆者於照護期間，協助個案心理調適及提供個別性護理，減輕個案的恐懼感並避免感染發生。案母更在指引中，利用減壓的技巧緩解緊張的情緒，最後協助個案順利完成療程並接受腎臟移植。

This article investigated the nursing experience of a young girl on peritoneal dialysis with end-stage renal failure who, due to limited kidney donors in Taiwan, were in preparation for ABO-incompatibility kidney transplantation with her mother as the donor. Because the blood type between the patient and her mother are incompatible, several sessions of a procedure of DFPP had been performed before kidney transplantation to reduce the titer of anti-RBC antibody. During the nursing period in the hemodialysis room between September 3 and September 10, 2012, the author utilized Watson's caring theory as a guideline and performed a comprehensive assessment. The identified health issues were fear, risk of infection, and caregiver role strain. The author assumed the role of a counselor and instructor to the patient during the nursing period, facilitating psychological adaptation, providing individualized care to ease the patient's fear and prevent infection. The patient's mother, the primary caregiver, used acquired stress-relieve skills to ease stress and anxiety. The patient eventually completed the therapeutic session and accepted the kidney transplantation.